DAVID A BALTIERRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093103

License Status

NOT RENEWED

Business

First Name

DAVID A

Last Name

BALTIERRA

Suffix

Business Name

DAVID A BALTIERRA MD

Original Issue Date

06/06/1996

Effective Date

06/06/1996

Expiration Date

07/31/1999

City

SHAKER HEIGHTS

State

Zip

44120

County

OHIO

Ever Disciplined

LastModifiedDate

09/20/2006